Distinguished Alumni Award

Nomination Form


After completing this form, please press the Submit button to e-mail your nomination LCC Foundation and Alumni Association. Or if you prefer, you may type or write your answers on plain paper and mail to:

LCC Foundation and Alumni Association

200 South 14th Street

Parsons, KS 67357


If you have questions, please e-mail Lindi Forbes at lindif@labette.edu, or telephone the LCC Alumni Association at (620) 820-1212.


Thank you for your help with this important project.

Date: (mm/dd/yyyy)


Nominee's Information

First Name: MI: Last Name:    Maiden Name:
City: State:

Zip Code:

Year Graduated LCC:

Phone Number (with area code): E-Mail Address:  
Spouse's Name:      

Colleges & Universities Attended:

Employer and Location:

Job Title/Assignment:

Previous Employers (include dates, company name, location, title and assignment):

Memberships & Offices (including professional, religious and civic organizations):

Community Activities, Honors and Awards:

Books or Articles Published:

Military Service & Responsibilities:

Other information you wish to share about the nominee:

--------------------------------- Thank You ----------------------------------------

Nominator's Information



City:      State:     Zip Code:

Daytime Phone Number (with area code):    -

E-Mail Address: